Clin Orthop Surg.  2013 Dec;5(4):306-313. 10.4055/cios.2013.5.4.306.

Clinical and Radiological Evaluation after Arthroscopic Rotator Cuff Repair Using Suture Bridge Technique

• Lee KW
• Seo DW
• Bae KW
• Choy WS

• KMID: 1787034
• DOI: http://doi.org/10.4055/cios.2013.5.4.306

Abstract

BACKGROUND
We retrospectively assessed the clinical outcomes and investigated risk factors influencing retear after arthroscopic suture bridge repair technique for rotator cuff tear through clinical assessment and magnetic resonance arthrography (MRA).
METHODS
Between January 2008 and April 2011, sixty-two cases of full-thickness rotator cuff tear were treated with arthroscopic suture bridge repair technique and follow-up MRA were performed. The mean age was 56.1 years, and mean follow-up period was 27.4 months. Clinical and functional outcomes were assessed using range of motion, Korean shoulder score, Constant score, and UCLA score. Radiological outcome was evaluated with preoperative and follow-up MRA. Potential predictive factors that influenced cuff retear, such as age, gender, geometric patterns of tear, size of cuff tear, acromioplasty, fatty degeneration, atrophy of cuff muscle, retraction of supraspinatus, involved muscles of cuff and osteolysis around the suture anchor were evaluated.
RESULTS
Thirty cases (48.4%) revealed retear on MRA. In univariable analysis, retear was significantly more frequent in over 60 years age group (62.5%) than under 60 years age group (39.5%; p = 0.043), and also in medium to large-sized tear than small-sized tear (p = 0.003). There was significant difference in geometric pattern of tear (p = 0.015). In multivariable analysis, only age (p = 0.036) and size of tear (p = 0.030) revealed a significant difference. The mean active range of motion for forward flexion, abduction, external rotation at the side and internal rotation at the side were significantly improved at follow-up (p < 0.05). The mean Korean shoulder score, Constant score, and UCLA score increased significantly at follow-up (p < 0.01). The range of motion, Korean shoulder score, Constant score, and UCLA score did not differ significantly between the groups with retear and intact repairs (p > 0.05). The locations of retear were insertion site in 10 cases (33.3%) and musculotendinous junction in 20 cases (66.7%; p = 0.006).
CONCLUSIONS
Suture bridge repair technique for rotator cuff tear showed improved clinical results. Cuff integrity after repair did not affect clinical results. Age of over 60 years and size of cuff tear larger than 1 cm were factors influencing rotator cuff retear after arthroscopic suture bridge repair technique.

Keyword

Rotator cuff tear; Suture bridge technique; Retear; Magnetic resonance arthrography

MeSH Terms

Adult
Aged
Analysis of Variance
Arthroscopy/*methods
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Orthopedic Procedures/*methods
Range of Motion, Articular
Retrospective Studies
Rotator Cuff/*injuries/radiography/*surgery
*Suture Techniques
Treatment Outcome

Figure

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  Fig. 1 Measurement of muscle atrophy by Warner et al. is based on oblique sagittal plane image medial to coracoid process. A line is drawn from the edge of the coracoid to the inferior scapular tip, from the inferior tip of the scapula to the spine, and from the scapular spine to the coracoid process. If the muscle is convex above the line, there is no atrophy line, moderate atrophy is present. If there is barely any muscle visible, severe atrophy exists. Reprint from Warner et al.15) with permission from Elsevier.

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